Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun;168(6):1114-1127.e5.
doi: 10.1053/j.gastro.2025.01.234. Epub 2025 Feb 4.

A Standardized Approach to Performing and Interpreting Functional Lumen Imaging Probe Panometry for Esophageal Motility Disorders: The Dallas Consensus

Dustin A Carlson  1 , John E Pandolfino  2 , Rena Yadlapati  3 , Marcelo F Vela  4 , Stuart J Spechler  5 , Felice H Schnoll-Sussman  6 , Kristle Lynch  7 , Adriana Lazarescu  8 , Abraham Khan  9 , Philip Katz  6 , Anand S Jain  10 , C Prakash Gyawali  11 , Milli Gupta  12 , Jose M Garza  13 , Ronnie Fass  14 , John O Clarke  15 , Reena V Chokshi  16 , Joan Chen  17 , Karthik Ravi  18 , Walter W Chan  19 , Shahnaz Sultan  20 , Vani J A Konda  21
Affiliations

A Standardized Approach to Performing and Interpreting Functional Lumen Imaging Probe Panometry for Esophageal Motility Disorders: The Dallas Consensus

Dustin A Carlson et al. Gastroenterology. 2025 Jun.

Abstract

Background & aims: Functional lumen imaging probe (FLIP) panometry provides assessment of the esophagogastric junction opening and esophageal body contractile activity during an endoscopic procedure and is increasingly being incorporated into comprehensive esophageal motility assessments. The aim of this study was to provide a standardized approach and vocabulary to the procedure and interpretation and update the motility classification scheme.

Methods: A working group of 19 FLIP panometry experts convened in a modified Delphi consensus process to produce and assess statements on the FLIP panometry procedure and interpretation. Three rounds of voting were conducted on an agreement scale of 1-9 for appropriateness, followed by face-to-face discussions and an opportunity for revisions of statements. The "percent agreement" was the proportion of votes with score ≥7 indicating level of agreement on appropriateness.

Results: A total of 40 statements were selected for final inclusion in the Dallas Consensus, including FLIP panometry protocol, interpretation of esophagogastric junction opening and contractile response, and motility classification scheme. Key statements included: "FLIP panometry should be interpreted in the context of the clinical presentation, the accompanying EGD [esophagogastroduodenoscopy] findings and other relevant complementary testing" (median response 9.0; 100% agreement). "A major motor disorder is unlikely in the setting of a 'normal' FLIP panometry classification" (median response 9.0; 94% agreement). "Diminished or absent contractile response with reduced esophageal opening (ie, nonspastic obstruction) supports the diagnosis of a disorder of EGJ [esophagogastric junction] outflow" (median response 8.5; 94% agreement).

Conclusions: The standardized approach for performance and interpretation of the Dallas Consensus can facilitate use of FLIP panometry in broad clinical settings.

Keywords: Achalasia; Dysphagia; Endoscopy; Impedance.

PubMed Disclaimer

References

    1. Carlson DA, Gyawali CP, Khan A, et al. Classifying Esophageal Motility by FLIP Panometry: A Study of 722 Subjects With Manometry. Am J Gastroenterol. 2021;116(12):2357–66. - PMC - PubMed
    1. Chen JW, Khan A, Chokshi RV, et al. Interrater Reliability of Functional Lumen Imaging Probe (FLIP) Panometry and High-Resolution Manometry for Assessment of Esophageal Motility Disorders. Am J Gastroenterol. 2023. - PMC - PubMed
    1. Fitch K. The Rand/UCLA appropriateness method user’s manual. Santa Monica: Rand; 2001. xiii, 109 p. p.
    1. Yadlapati R, Kahrilas PJ, Fox MR, et al. Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0((c)). Neurogastroenterol Motil. 2021;33(1):e14058. - PMC - PubMed
    1. Jaber F, Johnson WM, Wilson N, et al. Analysis of Reported Adverse Events Associated With the Use of Functional Lumen Imaging Probe Devices in the Esophagus and Stomach: An FDA MAUDE Database Study. Foregut. 2023;3(3):338–43.

Publication types

MeSH terms

LinkOut - more resources